Individual provider Active NPI

Yudisleidy Rodriguez Carralero

  • Nurse Practitioner
  • Humble, TX
National Provider Identifier
1306456736
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1306456736 Issued in TX
Practice address
12411 Tullich Run Dr
Humble, TX 77346-4624
Phone
(281) 492-4499
NPI assigned
Jul 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1306456736 TX Primary
Registered Nurse 163W00000X 984522 TX

Addresses

Primary practice location

12411 Tullich Run Dr
Humble, TX 77346-4624

Mailing address

12411 Tullich Run Dr
Humble, TX 77346-4624
Phone (281) 492-4499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
984522TXMDRegistered Nurse
1306456736TXMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: yudisleidy.rodriguez.1@17945.direct.athenahealth.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1306456736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12411 TULLICH RUN DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773464624",
            "telephone_number": "281-492-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12411 TULLICH RUN DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773464624",
            "telephone_number": "281-492-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ CARRALERO",
        "first_name": "YUDISLEIDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-31",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1306456736",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "984522",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.